Haitian officials confirmed Friday that a spreading cholera outbreak has killed 194 people and sickened more than 2,300 in the country's deadliest health problem since its devastating earthquake earlier this year.

Many of the sick have converged on St. Nicholas Hospital in the seaside city of St. Marc, where hundreds of dehydrated patients lay on blankets in a courtyard as they waited for treatment.

Meanwhile, lines of people tried to force their way through the hospital gates, but police blocked them from entering.

"They need some field hospitals put up as quickly as possible to be to take in the amount of people as they have. They need doctors, they need nurses," Baker said.

"The main worry at this point is that the disease might spread," said CBC freelance reporter Anzel Herz. "It is highly infectious and spreads extremely easily … the risk here is very severe."

The outbreak, which began in the rural Artibonite region, which hosts more than one million quake refugees, appeared to confirm relief groups' fears about sanitation for homeless survivors living in tarp cities and other squalid settlements.

Cases have now been confirmed outside of Artibonite, in Arcahaie, a town closer to the capital, Port-au-Prince, where hundreds of thousands of quake survivors live in tarp camps.

"It will be very, very dangerous," said Claude Surena, the president of the Haitian Medical Association. "Port-au-Prince already has more than 2.4 million people, and the way they are living is dangerous enough already."

Cholera is a waterborne bacterial infection spread through contaminated water. It causes severe diarrhea and vomiting that can lead to dehydration and death within hours. Treatment involves administering a salt-and-sugar-based rehydration serum.

No cholera outbreaks had been reported in Haiti for decades before the earthquake, according to the U.S. Centers for Disease Control and Prevention. Haitian officials, including President Rene Preval, have been pointing to the lack of severe disease outbreaks as a hard-to-see success of the quake response.

Canadian commitment

Prime Minister Stephen Harper said the Canadian government would immediately offer up to $1 million to respond to the outbreak

"Canada will continue to respond to the needs of the people of Haiti who are experiencing tremendous hardships in the aftermath of the earthquake that took place earlier this year," Harper said in statement issued from Montreux, Switzerland, where he is attending the Francophonie summit.

Former governor general Michaëlle Jean, who was born in Haiti, issued a news release Friday saying news of the cholera outbreak brings her "great sadness" and is a clear reminder that Haiti still needs help 10 months after the earthquake.

"I hope that the people of Canada and the world can once again show our solidarity with our brothers and sisters who continue suffering in Haiti," she said. "To the victims of this deadly disease, my thoughts and prayers are with you as you fight for your lives and care for your family and friends."

Disease could spread

With more than a million people left homeless by the disaster, however, experts have warned that disease could strike in the makeshift camps with nowhere to put human waste and limited access to clean water.

"This outbreak is likely to get much larger, given our experience with cholera epidemics in the past," said Dr. Jon Arbus of the Pan American Health Organization.

At the hospital, some patients, including 70-year-old Belismene Jean Baptiste, said they got sick after drinking water from a public canal.

"I ran to the bathroom four times last night vomiting," Jean Baptiste said.

In the severe form, patients lose litres of fluid from diarrhea and vomiting, said Dr. Kate Alberti, an epidemiologist in Montreal working with Médecins Sans Frontières, or Doctors Without Borders.

"The patient can dehydrate, and in fact they die of dehydration rather than anything else," said Alberti, who is leaving on Sunday for her fourth trip to Haiti.

She will be part of a team defining a strategy to control the outbreak, such as providing safe drinking water and sanitation and spreading messages about the importance of hand-washing.

The sick come from across the Artibonite Valley, a starkly desolate region of rice fields and deforested mountains. The area did not experience significant damage in the Jan. 12 quake, but has absorbed thousands of refugees from the devastated capital 70 kilometres south of St. Marc.

Doctors Without Borders in Haiti said teams have been sent to the region to try to determine the source of the disease and discourage people from moving, fearing that those seeking medical attention will quickly spread the infection to more populated areas.

Trucks loaded with medical supplies including rehydration salts were to be sent from Port-au-Prince to the hospital, said Jessica DuPlessis, an OCHA spokeswoman. Doctors at the hospital said they also needed more personnel to handle the flood of patients.

Elyneth Tranckil was among dozens of relatives standing outside the hospital gate as new patients arrived near death.

"Police have blocked the entry to the hospital, so I can't get in to see my wife," Tranckil said.

The U.S. Embassy in Port-au-Prince issued an advisory urging people to drink only bottled or boiled water and eat only food that has been thoroughly cooked.